In J (Blood Transfusion: Older Child: Jehovah’s Witnesses), Re [2024] EWHC 1034 (Fam), J was a baptised Jehovah’s Witness aged 17 years 7 months who was awaiting abdominal surgery. As a Jehovah’s Witness, he did not consent to the use of blood products in the event of a significant uncontrolled intra-operative or post-operative bleed [1 & 2]. The Applicant, the University Hospitals Plymouth NHS Trust, applied to the court for a declaration that it would be lawful and in J’s best interests for him to receive blood products if required in the event of an emergency in the surgery [4].

Cobb J explained that the Court of Appeal had set out the necessary criteria for a decision in E v Northern Care Alliance NHS Foundation Trust and F v Somerset NHS Foundation Trust [2021] EWCA Civ 1888 at [45]-[49]. The role of the Court was:

(i) to establish the relevant facts; in particular, the risk or risks surrounding the medical condition and/or treatment.;

(ii) to decide whether, on the facts, it was necessary medically to intervene; in particular, whether immediate action was necessary, or whether a decision to intervene might better be postponed;

(iii) if immediate medical action was necessary, to undertake “the all-important welfare assessment”, looking at the situation from the individual’s point of view and seeking to identify his or her best interests in the widest sense (Re E & F at [49]).

In his view, J was “a competent young person with an understanding, maturity, and intelligence which equips him well to make his own decision, and give consent, in relation to the medical treatment issues”, in line with the principles in Gillick v West Norfolk and Wisbech Area Health Authority and Another [1986] AC 112. He was capable of appreciating fully the nature and consequences of the proposed treatment and Cobb J was satisfied that the views which J expressed were “authentically his own, free from influence of his parents or others” [24]. He therefore declared that

“it is lawful, being J’s decision and in accordance with his best interests, for his treating clinicians not to administer whole blood or primary blood products, even if in the opinion of the treating clinicians the transfusion of blood or blood products may preserve J’s life, or prevent severe permanent injury or irreversible physical or mental harm … [and that] if prior to the procedure J consents to having such blood or blood products, such treatment will be provided as long as his clinicians consider this to be clinically indicated” [47].

In a postscript added on 7 May, he noted that the surgery had been successful and J was making a good recovery [48].